内容紹介
Summary
We report a case of recurrent colon cancer that achieved partial response with chemotherapy of combined 5-fluorouracil(5-FU), irinotecan, Leucovorin(FOLFIRI), and aflibercept. A 65-year-old man was diagnosed with colon cancer with lymph node metastasis. He underwent surgery, but after 1 year, he had a recurrence of peritoneal dissemination, nodal enlargement, and liver metastases. He received chemotherapy(mFOLFOX plus bevacizumab), but suffered progressive disease. Thereafter, FOLFIRI plus aflibercept was administered, and CT revealed a decrease in peritoneal dissemination after 2 cycles of chemotherapy. After 23 cycles, a PET-CT showed no evidence of the disease. We also examined 9 recent cases treated with aflibercept in terms of Grade 3 and 4 adverse effects, leukopenia, neutropenia, thrombocytopenia, hypertension, and sweating. Placental-derived growth factor(PIGF)has been reported to stimulate macrophages and induce production of IL-6, and thus it promotes inflammation and growth of extant cancer. Among the responses to chemotherapy based on the RECIST criteria, a partial response was significantly higher in patients with a low neutrophil-to-lymphocyte ratio(NLR)(p<0.05)compared to those with high NLR. As regards the relationship between NLR and OS in patients treated with FOLFIRI plus aflibercept, OS was significantly worse in patients with high NLR than those with low NLR(p<0.05). NLR may be a useful marker in conjunction with aflibercept treatment.
要旨
今回われわれは,65歳の大腸癌術後腹腔内再発リンパ節再発肝転移患者にFOLFIRI+afliberceptを2 cycle投与後にpartial response(PR)となり,23 cycle後のPET-CT検査では同部に集積を認めなかった。本症例を含めaflibercert投与9例について検討した。副作用として好中球減少,高血圧,発汗がみられた。また,PIGFは炎症に関連しているといわれており,neutrophil-to-lymphocyte ratio(NLR)が3以上の場合はPR症例が有意に少なく,予後が不良であった。
目次
We report a case of recurrent colon cancer that achieved partial response with chemotherapy of combined 5-fluorouracil(5-FU), irinotecan, Leucovorin(FOLFIRI), and aflibercept. A 65-year-old man was diagnosed with colon cancer with lymph node metastasis. He underwent surgery, but after 1 year, he had a recurrence of peritoneal dissemination, nodal enlargement, and liver metastases. He received chemotherapy(mFOLFOX plus bevacizumab), but suffered progressive disease. Thereafter, FOLFIRI plus aflibercept was administered, and CT revealed a decrease in peritoneal dissemination after 2 cycles of chemotherapy. After 23 cycles, a PET-CT showed no evidence of the disease. We also examined 9 recent cases treated with aflibercept in terms of Grade 3 and 4 adverse effects, leukopenia, neutropenia, thrombocytopenia, hypertension, and sweating. Placental-derived growth factor(PIGF)has been reported to stimulate macrophages and induce production of IL-6, and thus it promotes inflammation and growth of extant cancer. Among the responses to chemotherapy based on the RECIST criteria, a partial response was significantly higher in patients with a low neutrophil-to-lymphocyte ratio(NLR)(p<0.05)compared to those with high NLR. As regards the relationship between NLR and OS in patients treated with FOLFIRI plus aflibercept, OS was significantly worse in patients with high NLR than those with low NLR(p<0.05). NLR may be a useful marker in conjunction with aflibercept treatment.
要旨
今回われわれは,65歳の大腸癌術後腹腔内再発リンパ節再発肝転移患者にFOLFIRI+afliberceptを2 cycle投与後にpartial response(PR)となり,23 cycle後のPET-CT検査では同部に集積を認めなかった。本症例を含めaflibercert投与9例について検討した。副作用として好中球減少,高血圧,発汗がみられた。また,PIGFは炎症に関連しているといわれており,neutrophil-to-lymphocyte ratio(NLR)が3以上の場合はPR症例が有意に少なく,予後が不良であった。